Download Evaluation of whole body reaction time and one leg with eye closed

Open Journal of Epidemiology, 2012, 2, 22-27
http://dx.doi.org/10.4236/ojepi.2012.21004 Published Online February 2012 (http://www.SciRP.org/journal/ojepi/)
OJEpi
Evaluation of whole body reaction time and one leg with
eye closed balance in elderly Japanese*
Nobuyuki Miyatake1, Noriko Sakano1, Akira Yoshioka2, Tomohiro Hirao2, Takeyuki Numata3
1
Department of Hygiene, Faculty of Medicine, Kagawa University, Miki, Japan
Department of Public Health, Faculty of Medicine, Kagawa University, Miki, Japan
3
Okayama Southern Institute of Health, Okayama Health Foundation, Okayama, Japan
Email: [email protected]
2
Received 28 November 2011; revised 19 January 2012; accepted 27 January 2012
ABSTRACT
We evaluated whole body reaction time and one leg
with eye closed balance in elderly Japanese. A total of
2059 elderly Japanese (730 men and 1329 women),
aged 60 - 79 years, were enrolled in the cross-sectional
investigation study. Anthropometric parameters, whole
body reaction time and one leg with eye closed balance were measured. Whole body reaction time was significantly higher and one leg with eye closed balance
was significantly lower in 70’s than those in 60’s in
both sexes. Two hundred twenty seven men (31.1%)
and 533 women (40.1%) were having no medications.
In men, whole body reaction time was significantly
higher and one leg with eye closed balance was significantly lower in subjects with medications than those
in subjects without in 60’s. However, significant differences of whole body reaction time and one leg with
eye closed balance between subjects with and without
medications in men with 70’s and women with 60’s
and 70’s were not noted. This standard mean value
may provide a useful reference database for evaluating whole body reaction time and one leg with eye
closed balance in Japanese elderly subjects.
Keywords: Elderly Japanese; Whole Body Reaction
Time; One Leg with Eye Closed Balance
1. INTRODUCTION
Rate of elderly subjects (over 65 years) in Japan are dramatically increased and has become public health challenge in Japan. For example, 28,216,000 subjects (22.1%)
are reported to be over 65 years old in Japan [1].
It has been shown that obese subjects have a high mortality rate [2] and have linked to atherogenic risk factors,
such as hypertension, coronary heart disease, diabetes mellitus and dyslipidemia [3]. In addition, physical fitness
*
There is no conflict of interest.
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was a graded, independent, long-term predictor of mortality from cardiovascular causes in healthy, middle-aged
men [4]. Lower and declining muscle strength was also
associated with increased mortality, independent of physical activity and muscle mass [5]. We have previously
showed that anthropometric parameters, muscle strength,
flexibility and aerobic exercise level in elderly Japanese.
Especially in elderly subjects without medications, this
standard mean value in 60’s and 70’s may provide a useful database for evaluating anthropometric parameters and
physical fitness [6]. However, according to other physical
fitness i.e. agility and balance, there are few studies that
focused on reductions in mortality or the prevention of lifestyle-related diseases, and the optimal level was not defined. Therefore, evaluation of agility i.e. whole body reaction time and balance i.e. one leg with eye closed balance
still remains to be investigated in elderly Japanese without medications.
In this study, we evaluated whole body reaction time and
one leg with eye closed balance in elderly Japanese and
compared those parameters between subjects with and
without medications.
2. SUBJECTS AND METHODS
2.1. Subjects
A total of 2059 elderly subjects (730 men and 1329 women), aged 60 - 79 years, was enrolled in this cross-sectional investigation study. All subjects met the following
criteria: 1) they had been wanting to change their lifestyle i.e., diet and exercise habits, and had received an
annual health checkup from June 1997 to Dec 2009 at
Okayama Southern Institute of Health; 2) their anthropometric, whole body reaction time and one leg with eye
closed balance measurements had been taken as part of
their annual health checkups; and 3) they provided written informed consent (Table 1).
The study was approved by the Ethics Committee of
Okayama Health Foundation.
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N. Miyatake et al. / Open Journal of Epidemiology 2 (2012) 22-27
Table 1. Clinical profiles of enrolled subjects.
Men (n = 730)
Women (n = 1329)
Mean ± SD
Minimum
Maximum
Mean ± SD
Minimum
Maximum
Age
65.6 ± 4.6
60
79
64.8 ± 4.1
60
79
Height (cm)
164.4 ± 5.5
145.3
180.2
151.9 ± 5.0
136.2
167.0
Body weight (kg)
65.9 ± 9.3
40.1
112.2
55.1 ± 7.6
33.4
92.4
Body mass index (kg/m2)
24.3 ± 3.0
16.2
40.9
23.9 ± 3.1
15.4
41.9
Abdominal circumference (cm)
86.0 ± 9.2
61.6
127.0
78.7 ± 9.1
54.7
121.6
Hip circumference (cm)
91.9 ± 5.5
77.8
122.7
90.2 ± 5.2
69.0
120.5
Whole body reaction time (sec)
0.44 ± 0.10
0.24
1.01
0.46 ± 0.10
0.26
0.99
One leg with eye closed balance (sec)
9.6 ± 10.7
1.0
93.0
10.1 ± 12.0
1.0
120.0
Number of subjects without medications (%)
227 (31.1)
533 (40.1)
2.2. Anthropometric Measurements
The anthropometric parameters were evaluated by using
the following respective parameters such as height, body
weight, body mass index (BMI), abdominal circumference and hip circumference. BMI was calculated by weight/[height]2 (kg/m2). The abdominal circumference was
measured at the umbilical level and the hip was measured at the widest circumference over the trochanter in
standing subjects after normal expiration [7].
2.3. Whole Body Reaction Time
Whole body reaction time was measured by using THP15 (Sakai, Tokyo, Japan) (Figure 1) as follows. Subjects
stood still with a posture to be able to change immediately and concentrated attention on a red lamp. When the
subjects watch the lamp shined, they jumped as early as
possible. Average second of five trials that both legs
completely left from a floor was employed to be whole
body reaction time [8].
Figure 1. Measurements of whole body reaction time photographed at Okayama Southern Institute of Health, Okayama, Japan.
2.4. One Leg with Eye Closed Balance
The examiner first asks the subjects to decide on which
leg they would like to stand. The subjects are then asked
to stand initially in a relaxed stance with their weight
evenly distributed between both. With their eyes close,
the subjects are instructed to stand on the leg they have
selected, without using any assistive device, and keeping
their arms by their sides. The test is over after 120s has
elapsed, when the stance foot shifts, or when the lifted
foot is replaced on the board, whichever occurs first. To
prevent falls or injuries, the examiner stands close to the
subjects throughout the trial (Figure 2) [9].
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Figure 2. Measurements of one leg with eye closed balance photographed at Okayama Southern Institute of Health,
Okayama, Japan.
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N. Miyatake et al. / Open Journal of Epidemiology 2 (2012) 22-27
2.5. Medications
The data on medications were obtained at interviews conducted by well-trained medical staff using the structured
method. The subjects were asked if they currently take
medications i.e diabetes, hypertension, dyslipidemia and/
or orthopedic diseases. When the answer was “yes”, they
were classified as subjects with medications. When the
answer was “no”, they were classified as subjects without medications.
2.6. Statistical Analysis
Data are expressed as means ± standard deviation (SD)
values. A comparison of parameters between the 2 groups
was made using the unpaired t-test: p < 0.05 was considered to be statistically significant.
3. RESULTS
Clinical profiles are summarized in Table 1. Twenty hundred and twenty seven men (31.1%) and 533 women
(40.1%) were take no medications.
We compared the clinical parameters between subjects
60’s and 70’s (Table 2). In men, height, body weight,
BMI and hip circumference in 60’s were significantly
higher than those in 70’s. However, abdominal circumference in 60’s was similar to that in 70’s. In women,
height was significantly higher and abdominal circumference was significantly lower in 60’s than those in 70’s.
Whole body reaction time was significantly lower and
one leg with eye closed balance was significantly higher
in 60’s than those in 70’s in both sexes.
We further analyzed clinical parameters between subjects with and without medications (Table 3). There were
significant differences of anthropometric parameters (except height), whole body reaction time and one leg with
eye closed balance between men with and without medications. In women, there were also significant differences of anthropometric parameters (except height and hip
circumference), whole body reaction time and one leg
with eye closed balance between subjects with and without medications.
In addition, in 60’s, significant differences of whole
body reaction time and one leg with eye closed balance
between men with and without medications, and body
weight, BMI, abdominal circumference and hip circumference between women with and without medications were
noted. In 70’s, anthropometric parameters were significantly higher in men with medications than those in men
without medications. There were not significant differences of other parameters between subjects with and
without medications (Table 3).
We found that there were significant differences of some
parameters between subjects with and without medications. We finally compared parameters between 60’s and
70’s in subjects without medications (Table 4). In men,
anthropometric parameters and one leg with eye closed
balance were significantly lower and whole body reaction time was significantly higher in 70’s than those in
60’s. In women, whole body reaction time was significantly higher, height and one leg with eye closed balance
were significantly lower in 70’s than those in 60’s. There
were no differences of other parameters between 60’s
and 70’s in subjects without medications.
Table 2. Comparison of clinical parameters in all subjects.
Men
Women
60 - 69
70 - 79
Number of subjects
589
141
Height (cm)
164.8 ± 5.3
162.7 ± 5.9
Body weight (kg)
66.5 ± 9.0
Body mass index (kg/m2)
60 - 69
70 - 79
1140
189
<0.0001
152.2 ± 4.9
149.8 ± 5.0
<0.0001
63.3 ± 10.0
0.0002
55.2 ± 7.6
54.5 ± 7.6
0.2529
24.5 ± 3.0
23.8 ± 3.0
0.0279
23.8 ± 3.1
24.3 ± 3.2
0.0550
Abdominal circumference (cm)
86.1 ± 9.1
85.6 ± 9.6
0.5186
78.2 ± 8.9
81.7 ± 10.0
<0.0001
Hip circumference (cm)
92.2 ± 5.4
90.7 ± 5.6
0.0040
90.2 ± 5.2
89.9 ± 5.3
0.4198
Whole body reaction time (sec)
0.43 ± 0.09
0.49 ± 0.13
<0.0001
0.45 ± 0.09
0.52 ± 0.12
<0.0001
One leg with eye closed balance (sec)
10.6 ± 11.5
5.2 ± 4.6
<0.0001
10.9 ± 12.7
5.0 ± 4.3
<0.0001
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p
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N. Miyatake et al. / Open Journal of Epidemiology 2 (2012) 22-27
Table 3. Comparison of clinical parameters between subjects with and without medications as classified by age groups.
Men
Women
Medication (–)
Medication (+)
Number of subjects
227
503
Height (cm)
164.2 ± 5.4
164.5 ± 5.5
Body weight (kg)
64.5 ± 8.7
Body mass index (kg/m2)
p
Medication (–)
Medication (+)
p
533
796
0.3979
152.0 ± 5.2
151.8 ± 4.9
0.3890
66.5 ± 9.5
0.0090
54.3 ± 7.3
55.6 ± 7.8
0.0015
23.9 ± 2.7
24.5 ± 3.1
0.0089
23.5 ± 3.0
24.2 ± 3.2
0.0002
Abdominal circumference (cm)
84.6 ± 9.0
86.7 ± 9.2
0.0057
77.3 ± 8.7
79.6 ± 9.3
<0.0001
Hip circumference (cm)
91.2 ± 5.0
92.2 ± 5.6
0.0279
89.9 ± 5.0
90.4 ± 5.4
0.0781
Whole body reaction time (sec)
0.43 ± 0.10
0.45 ± 0.1
0.0012
0.45 ± 0.09
0.46 ± 0.10
0.0016
One leg with eye closed balance (sec)
12.0 ± 12.9
8.5 ± 9.4
<0.0001
11.2 ± 13.5
9.4 ± 10.9
0.0072
Number of subjects
193
396
485
655
Height (cm)
164.8 ± 5.0
164.9 ± 5.4
0.8700
152.2 ± 5.1
152.3 ± 4.8
0.8571
Body weight (kg)
65.7 ± 8.2
66.9 ± 9.4
0.1128
54.4 ± 7.4
55.8 ± 7.7
0.0021
Body mass index (kg/m2)
24.2 ± 2.6
24.6 ± 3.1
0.0812
23.5 ± 3.0
24.1 ± 3.2
0.0014
Abdominal circumference (cm)
85.3 ± 8.8
86.5 ± 9.3
0.1439
77.1 ± 8.6
79.0 ± 9.0
0.0004
Hip circumference (cm)
91.7 ± 4.7
92.4 ± 5.7
0.1868
89.9 ± 5.0
90.5 ± 5.3
0.0401
Whole body reaction time (sec)
0.42 ± 0.08
0.44 ± 0.09
0.0009
0.44 ± 0.09
0.45 ± 0.09
0.0678
One leg with eye closed balance (sec)
13.0 ± 13.5
9.4 ± 10.1
0.0003
11.7 ± 14.0
10.3 ± 11.6
0.0592
Number of subjects
34
107
48
141
Height (cm)
160.7 ± 6.3
163.3 ± 5.7
0.0207
150.4 ± 5.6
149.7 ± 4.7
0.3971
Body weight (kg)
58.2 ± 8.8
64.9 ± 9.9
0.0006
53.3 ± 6.2
54.9 ± 8.0
0.1964
Body mass index (kg/m2)
22.5 ± 3.0
24.3 ± 2.9
0.0031
23.6 ± 3.2
24.5 ± 3.2
0.1118
Abdominal circumference (cm)
80.5 ± 9.4
87.2 ± 9.1
0.0003
79.4 ± 9.7
82.5 ± 9.9
0.0624
Hip circumference (cm)
88.2 ± 5.9
91.5 ± 5.3
0.0031
90.0 ± 4.6
89.9 ± 5.5
0.8791
Whole body reaction time (sec)
0.48 ± 0.16
0.49 ± 0.11
0.7586
0.50 ± 0.11
0.52 ± 0.13
0.2615
One leg with eye closed balance (sec)
6.2 ± 5.6
4.9 ± 4.2
0.1391
5.3 ± 3.7
4.9 ± 4.5
0.5943
All subjects
60 - 69
70 - 79
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N. Miyatake et al. / Open Journal of Epidemiology 2 (2012) 22-27
Table 4. Comparison of clinical parameters in subjects without medications.
Men
Women
60 - 69
70 - 79
Number of subjects
193
34
Height (cm)
164.8 ± 5.0
160.7 ± 6.3
Body weight (kg)
65.7 ± 8.2
Body mass index (kg/m2)
60 - 69
70 - 79
485
48
<0.0001
152.2 ± 5.1
150.4 ± 5.6
0.0188
58.2 ± 8.8
<0.0001
54.4 ± 7.4
53.3 ± 6.2
0.3148
24.2 ± 2.6
22.5 ± 3.0
0.0013
23.5 ± 3.0
23.6 ± 3.2
0.7063
Abdominal circumference (cm)
85.3 ± 8.8
80.5 ± 9.4
0.0040
77.1 ± 8.6
79.4 ± 9.7
0.0803
Hip circumference (cm)
91.7 ± 4.7
88.2 ± 5.9
0.0001
89.9 ± 5.0
90.0 ± 4.6
0.8551
Whole body reaction time (sec)
0.42 ± 0.08
0.48 ± 0.16
0.0004
0.44 ± 0.09
0.50 ± 0.11
<0.0001
One leg with eye closed balance (sec)
13.0 ± 13.5
6.2 ± 5.6
0.0043
11.7 ± 14.0
5.3 ± 3.7
0.0016
4. DISCUSSION
We evaluated whole body reaction time and one leg with
eye closed balance in elderly Japanese. Especially in
elderly subjects without medications, this standard mean
value in 60’s and 70’s may provide a useful reference
database for evaluating whole body reaction time and
one leg with eye closed balance.
For preventing life-style related diseases, the level of
maximal oxygen uptake and muscle strength was recommended in exercise and physical activity reference quantity for health promotion 2006 (EPARQ2006) by ministry of health, labor and welfare of Japan. However, according to other physical fitness i.e. agility and balance, the
optimal level was not defined [10]. Reaction time is a
physiological entity that has been linked as a causal factor in the incidence of falls in the elderly population [11].
In some literatures, whole body reaction time was analyzed in elderly Japanese. Higuchi et al. have reported that
the whole body reaction time was increased with aging
over 50’s by 1028 Japanese, aged 20 - 85 years [12]. Cao
et al. have reported that the effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community dwelling elderly women (n = 20). They showed that the whole body reaction time significantly decreased from 0.48 ± 0.07 sec
to 0.45 ± 0.07 sec (6.4%) after intervention [11]. In addition, they also explored the effect of 12-month exercise
and nutritional intervention by voluntary, homebased exercise [13].
According to one leg with eye closed balance, reference value for one leg balance time in elderly subjects varied widely from study to study [9], because various
procedure are used to carry out the test i.e. eye-opened
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p
and eye-closed. At present, there is no consensus on
whether it is better to perform the test with the eye open
or closed. Potvin et al. reported and concluded that the
test was more effective with the eyes closed [14]. The
mean reported one leg balance time of women aged 70 79 years ranging widely by as much as 6.9 - 32.9 sec
[15].
In this study, we measured 730 men and 1329 women
over the age of 60. In addition, we compared parameters
between subjects with and without medications. This information gathered may serve as a useful reference database for evaluating whole body reaction time and one leg
with eye closed balance in elderly Japanese.
Potential limitations remain in this study. First, our study
was a cross sectional and not a longitudinal study. In
addition, although there were differences of height or weight between 60’s and 70’s, cross sectional study design
and/or difference of the birth cohort may affect these results. These greatly decrease the validity of the study. Second, the 2059 elderly subjects, all of whom wanted to
change their lifestyle, underwent measurements for this
study at Okayama Southern Institute of Health: they were
therefore more health-conscious than the average person,
especially may be in 70’s. Thus, this study has a big selection bias. Third, the small sample size in especially 70’s
without medications might make it difficult to compare
whole body reaction time and one leg with eye closed
balance between subjects with and without medications.
Therefore, this study does not have enough participants
to obtain the standard mean value for the Japanese population. Further prospective, large sample size and community based studies are urgently needed in elderly Japanese.
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N. Miyatake et al. / Open Journal of Epidemiology 2 (2012) 22-27
5. ACKNOWLEDGEMENTS
Numata, T. (2007) Comparison of whole body reaction
time between Japanese men with and without metabolic
syndrome. International Journal of Sport and Health Sciences, 5, 122-124. doi:10.5432/ijshs.5.122
This research was supported in part by Research Grants from the Ministry of Health, Labor, and Welfare, Japan.
[9]
REFERENCES
[1]
Health and Welfare Statistics Association (2009) Journal
of Health and Welfare Statistics, 56, 39 (in Japanese).
[2]
Sjostrom, L.V. (1992) Mortality of severely obese subjects. The American Journal of Clinical Nutrition, 55,
516S-523S.
[3]
Pouliot, M.C., Despres, J.P., Nadeeau, A., Moorjani, S.,
Prud’sHomme, D., Lupien, P.J. and Tremblay, A. (1992)
Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels. Diabetes, 41,
826-834. doi:10.2337/diabetes.41.7.826
[4]
Sandvik, L., Erikssen, J., Thaulow, E., Erikssen, G.,
Mundal, R. and Rodahl, K. (1993) Physical fitness as a
predictor of mortality among healthy, middle-aged Norwegian men. The New England Journal of Medicine, 25,
533-537. doi:10.1056/NEJM199302253280803
[5]
Metter, E.J., Talbot, L.A., Schrager, M. and Conwit, R.
(2002) Skeletal muscle strength as a predictor of all-cause
mortality in healthy men. The Journals of Gerontology
Series A, 57, B359-B365. doi:10.1093/gerona/57.10.B359
[6]
Miyatake, N., Miyachi, M., Tabata, I. and Numata, T.
(2011) Evaluation of anthropometric parameters and physical fitness in elderly Japanese. Environmental Health and
Preventive Medicine, 17, 62-68.
[7]
[No authors listed] (2005) Definition and the diagnostic
standard for metabolic syndrome—Committee to evaluate
diagnostic standards for metabolic syndrome. Nippon Naika Gakkai Zasshi, 94, 794-809.
doi:10.2169/naika.94.794
[8]
Miyatake, N., Miyachi, M., Nishikawa, H., Saito, T. and
Copyright © 2012 SciRes.
27
Michikawa, T., Nishiwaki, Y., Takebayashi, T. and Toyama, Y. (2009) One-leg standing test for elderly populations. Journal of Orthopaedic Science, 14, 675-685.
doi:10.1007/s00776-009-1371-6
[10] National Institute of Health and Nutrition, Japan (2011).
http://www.nih.go.jp/eiken/programs/pdf/epar2006.pdf
[11] Cao, Z.B., Maeda, A., Shima, N., Kurata, H. and Nishizono, H. (2007) The effect of a 12-week combined exercise intervention program on physical performance and
gait kinematics in community-dwelling elderly women.
Journal of Physiological Anthropology, 26, 325-332.
doi:10.2114/jpa2.26.325
[12] Higuchi, M., Okada, A., Hisamoto, S. and Miyano, M.
(2008) Study of the results of measurements of Japanese
physical fitness. Japanese Journal of Physiological Anthropology, 13, 115-124 (in Japanese).
[13] Cao, Z.B., Tabata, I. and Nishizono, H. (2009) Good
maintenance of physical benefits in a 12-month exercise
and nutritional intervention by voluntary, home-based
exercise: A 6-month follow-up of a randomized controlled trial. Journal of Bone and Mineral Metabolism, 27,
182-189. doi:10.1007/s00774-008-0022-x
[14] Potvin, A.R., Syndulko, K., Tourtellotte, W.W., Lemmon,
J.A. and Potvin, J.H. (1980) Human neurologic function
and the aging process. Journal of American Geriatrics
Society, 28, 1-9.
[15] Rudisill, M.E. and Toole, T. (1993) Gender differences in
motor performance of 50- to 79-year-old adults. Perceptual and Motor Skills, 77, 939-947.
doi:10.2466/pms.1993.77.3.939
OPEN ACCESS